Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

Jean-Louis Petit

Jean Louis Petit
(1674 – 1750)

French surgeon and anatomist, Jean Louis Petit was born in Paris in on March 13, 1674.  His family rented an apartment at his house to Alexis Littre (1658 – 1726), a French anatomist. Petit became an apprentice of Littre at seven years of age, helping him in the dissections for his lectures and at an early age became the assistant in charge of the anatomic amphitheater.

Because of Petit’s dedication to anatomy and medicine, in 1690 at the age of sixteen, became a disciple of a famous Paris surgeon, Castel.

In 1692, Petit entered the French army and performed surgery in two military campaigns. By 1693 he started delivering lectures and was accepted as a great surgeon, being invited to the most difficult operations.  In 1700 he was appointed Chief Surgeon of the Military School in Paris and in the same year he received the degree of Master of Surgery from the Faculty of Paris.

In 1715 he was made a member of the Royal Academy of Sciences and an honorary member of the Royal Society of London. He was appointed by the King as the first Director General of the Royal Academy of Surgery when it was founded in 1731.

Petit’s written works are of historical importance.  “Traite des Maladies des Os” ( A Treatise on Bone Diseases);  “Traite des Maladies Chirurgicales et des Operation” (A Treatise on Surgical Diseases and their Operations” This last book was published posthumously in 1774. He also published a monograph on hemorrhage, another on lachrymal fistula, and others.

He was one of the first to perform choIecystotomy and mastoidotomy. His original tourniquet design for amputations saved many in the battlefield and the design of the same surgical instrument today has not changed much since its invention by him.

His name is remembered in the lumbar triangle, also called the "triangle of Petit", and the abdominal hernia that can ensue through that area of weakness, the lumbar hernia or "Petit's hernia".

Sources:
1. “Jean Louis Petit – A Sketch of his Life, Character, and Writings” Hayne, AP San Fran Western Lancet 1875 4: 446-454
2. “Oeuvres compl?tes de Jean-Louis Petit” 1837 Imprimerie de F. Chapoulaud
3. Extraits de l'eloge de Jean-Louis Petit Ius dans Ia seance publique de I' Academie royale de chirurgie du 26 mai 1750” Louis A. Chirurgie 2001: 126 : 475- 81


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Celsus and his influence on Medicine and Surgery

Aulus Cornelius Celsus and Title Page De Medicina Libri Octo”
Celsus and Title Page De Medicina Libri Octo”
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Aulus Cornelius Celsus (25 BC - 45 AD) was Roman, probably born in the south of France. A controversial character, many dispute that he was even a physician or that he actually did what is mentioned in his opus magnum “De Medicina Libri Octo.” According to some, he was what today would be considered a compiler and editor of larger books where each chapter is written by a different author. Others present Celsus as a learned scholar of noble origin, a famous physician, either way, he influenced Medicine and Surgery for centuries. Some of his canons and medical terms he coined are in use today. such as omentum, cancer, vertebra, scalpel, etc.

He is the first to describe the four pillars of inflammation: dolor (pain), rubor (redness), calor (fever), and tumor (swelling) , and in passing criticizes Erasistratus on being wrong about inflammation. In his book he states “Notæ vero inflammationis sunt quatuor, rubor, et tumor, cum calore et dolore. Quo magis erravit Erasistratus, qui febre nullam sine hac esse dixir.” Translates as: “Note that there are four signs of inflammation: redness and swelling, with heat and pain. So much was Erasistratus mistaken, when he declared there was no fever without it.” Celsus popularized the use of the term “cancer”. although it was first used by Galen of Pergamon.

Not much is known about his life or work. Quintilian mentions a work of Celsus on rhetoric, but that work is lost. Quintilian, who apparently was not a fan of Celsus, writes: “…when even Cornelius Celsus, a man of a moderate share of genius, has not only composed treatises on all these arts, but has also left precepts of the military art, agriculture, and medicine.” His quote is what leads Alexander of Padua to state that his book “De Medicina, Libri Octo” is but a small part of a larger treatise that was called “The Arts.” Celsus is known by his book “De Medicina, Libri Octo,” (On Medicine, eight books). This book is sometimes presented as “De Re Medicina, Libri Octo.” Apparently, this book was part of a larger work by Celsus that has disappeared from History. This medical book was handwritten and was lost to history until one copy was discovered in the Vatican Library and released for copying as manuscripts. Of interest is the fact that the book found was titled "Aulii Cornelii Celsi liber sextus. idemque medicinæ primus," making it understood that these were six books, not eight! This was one of the first medical books to be printed upon the invention of the printing press by Gutenberg.

The first book begins with the principles for the preservation of health; the second is dedicated to the symptoms of diseases; the third is describes treatment of diseases which affect the whole organism and the fourth is focused on the diseases where the cause is found only in certain parts of the body, such as in head, lungs etc. The fifth book is dedicated to pharmacology. The sixth, seventh, and the eighth book deal with surgery, wounds, and fractures.

His book describes the importance of cleanliness of a wound and the use of topical treatment that today would be considered antiseptics. His contributions to surgery are many including anatomy of the eye, the description of ophthalmic diseases, methods of preventive treatment and surgery including eyelid surgery. He is probably the first to describe cataract surgery.

The eighth book, almost entirely dedicated to dislocations and fractures, provides an extensive description of head injuries such as extradural hematomas, lesions distant from the impact point, and intracranial damage in cases with no overlying fractures. He also provided the first description of brain swelling exceeding the level of the skull, described several surgical indications and craniotomy techniques, recommended treatment for depressed fractures (which had been previously considered untreatable), and detailed the surgical instruments employed.

De Medicina was among the first medical books to be printed (Florence, 1478), and more than 50 editions have appeared; it was required reading in most medical schools to the present century. It is the principal historical authority for the doctrinal medical teachings of Roman antiquity. The surgical section, which even Joseph Lister studied in the 19th century, is perhaps the best part of the treatise.

W. G. Spencer, the most recent translator of his works, supports an older, minority view that the details of medical procedure, the experienced judgment shown in the selection of treatment, and the frequent use of the first person reveal an author with an intimate acquaintance of clinical medicine who must have been himself a practitioner of the medical arts.

Because of this book and the clarity of the disease descriptions and treatments both pharmacological and surgical. Celsus has been lauded as one of the Fathers of Medicine and Surgery. His influence has stood the test of time and was read well into the 1800’s.

Personal note: This article was motivated by the recent acquisition of a 1713 copy of De Medicina, that is now part of my library. The book belonged to Dr. Harry Kaufmann Hines, a renown radiologist who lived and worked in Cincinnati, OH. The book was a gift to him from his sister-in-law Erma Wright Tateman neé Sharkey in August 1961. Dr. Miranda

Sources:
1. “The Contribution of Aulus Cornelius Celsus (25 B.C.–50 A.D.) to Eyelid Surgery” Davide Lazzeri, Tommaso Agostini, Michele Figus, Marco Nardi, Giuseppe Spinelli, Marcello Pantaloni & Stefano Lazzeri (2012), Orbit, 31:3, 162-167
2. “Aulus Cornelius Celsus and the Head Injuries” GiuseppeTalamonti Giuseppe D'Aliberti, MarcoCenzato World Neurosurgery Volume 133, January 2020, Pages 127-134
3. “A. Cornelius Celsus of medicine. In eight books.” Translated, with notes critical and explanatory, by James Greive, M.D. 1756

For anyone interested in reading an online copy of this book, you can find it here.  For the translation by Greive click here.